微环境下牙髓再生策略及研究进展

Research progress in pulp tissue regeneration strategy in microenvironment

牙髓病和根尖周病是人类口腔的常见病,其传统治疗方法是根管治疗,即通过根管机械预备、化学消毒及严密充填等步骤,彻底清除和控制感染,修复或预防根尖周病变。目前,根管治疗虽然成功率较高,但仍存在一系列问题。牙髓再生在促进根管内牙髓样组织形成方面,吸引了研究者越来越多的关注。再生牙髓病学的最终目标是形成功能性牙髓-牙本质复合体,即具备内层血管和神经,沿根管壁排列的外层成牙本质细胞,及分泌基质形成新的牙本质,进而恢复牙髓活力。干细胞、支架、生物信号分子以及再生微环境是影响牙髓再生的关键性组织工程因素。围绕上述要素及临床程序对牙髓再生的策略及应用进行综述。

Pulpal and periapical diseases are the common diseases in human diseases. The traditional treatment method for these diseases is root canal treatment, which is to completely remove and control infection, repair or prevent periapical lesions by root canal mechanical preparation, chemical disinfection and filling. At present, although root canal treatments have a high success rate, there are still a series of problems. Dental pulp regeneration has attracted more and more attention from researchers in promoting the formation of pulp-like tissue in root canals. The ultimate goal of regenerative endodontics is to form a functional endodontic-dentin complex with inner blood vessels and nerves, outer layers of dentin cells arranged along the root canal wall, and new dentin formed by secreting matrix, so as to restore pulp vitality. Stem cells, scaffolds, biosignal molecules, and regenerative microenvironment are key tissue engineering factors that affect pulp regeneration. In this paper, the strategies and applications of pulp regeneration were reviewed around the above factors and clinical procedures.